218 THE ACUTE PNEUMONIAS 



few instances, but sometimes the pneumococcus is the causal 

 agent ; and in tubercular meningitis the tubercle bacillus of 

 course is present, especially in the nodules along the sheaths of 

 the vessels. An invasion of the meninges by the anthrax 

 bacillus occurs, but is a rare condition ; it is attended by diffuse 

 haemorrhage in the subarachnoid space. 



In conclusion here it may be stated that mixed infections 

 may occur in meningitis. Thus the pneumococcus has been 

 found associated with the tubercle bacillus and also with the 

 diplococcus intracellularis. Further, in infection with the latter, 

 Gram-negative bacilli of a diphtheroid appearance have also been 

 observed ; the significance of these is unknown. 



